Periodontal Disease and Overall Health: A Clinician's Guide

CHAPTER 1 Overview 3alpha­and­interleukins­1­and­6,­often­foundin­the circu­lation­of­patients­with­perio­dontal­disease.­There­are­other­conditionsthat­also­contrib­ute­to­a­systemic­inflammatory­response­including­rheumatoid­arthritis,psoriasis,­and­obesity. This­chronic­systemicinflammatory­response­in­turn­increasesthe­risk­for­­athero­sclerotic­disease,­diabetesand­complications­of­diabetes, adverse­pregnancy­outcomes,­and­possibly­some­cancers.The­research­supporting­these­associationswill­be­discussed­in­detail­in­the­followingchapters.GOALS FOR THIS TEXTBOOKMuch­research­is­focused­on­understanding­how­periodontal­disease­increasesthe­risk­for­systemic­diseases.­It­is­not­yetclear­what­impact­the­biofilm­in­the­oral­cavity­might­haveon­distant­sites­and­organs;likewise­the­role­of­the­inflammatory­response­is­not­fully­understood.­Some­of­thechapters­in­this­textbook­will­review­the­bio­logicplausibility­for­periodontal­disease­as­arisk­for­systemic­conditions.­Mechanismsthrough­which­periodontal­disease­can­confer­this­risk­will­also­be­presented.The­overall­goal­of­this­textbook­is­topresent­the­emerging­and­compelling­evidence­that­periodontal­disease­is­a­risk­forseveral­systemic­conditions­and­to­look­at­therole­of­oral­health­in­contributing­to­overallhealth.­This­book­also­seeks­to­provide­thereader­with­a­guide­to­patient­management­inwhich­dentistry­and­medicine­work­together.Textbook OrganizationThe­chapters­in­this­book are­organizedin­the­following­manner: The­initial­chaptersfollowing­this­one­outline­the­basics­of­under­standing­periodontal­disease­and­its­interrelationship­with­systemic­disease:­Chapter2­discusses­the­causes­and­pathogenesis­ofperiodontal­disease;­the­role­of­infection­andinflammation­in­periodontal­disease­is­examined­in­Chapter­3;­and­the­history­of­theoral­disease-systemic­disease­relationship­isexplained­in­Chapter­4.An­overview­of­diabetes­(Chapter­5)and­atherosclerotic­diseases­(Chapter­7)­arefollowed­by­chapters­that­describe­the­relation­ship­of­periodontal­disease­to­these­conditions­(Chapters­6­and­8,­respectively).­Thenext­chapters­examine­the­evidence­for­perio­dontaldisease­as­a­risk­for­adverse­pregnancy­outcomes­(Chapter­9),­respiratory­diseases­(Chapter­10),­osteoporosis­(Chapter11),­rheumatoid­arthritis­(Chapter­12),­andcancer­(Chapter­13).­The­ final­section­of­the­textbook discussescomanagement­of­periodontal­diseasein­diabetes­(Chapter­14),­cardiovascular­disease­(Chapter­15),­pregnancy­(Chapter­16),and­other­conditions that­are­associated­withperiodontal­disease­(Chapter­17).­Finally,Chapter­18­describes­the­role­of­dental­professionals­in­the­education­of­the­public­andother­health­professionals about the­oralhealth-general­health­inter-relationship.Our Hope for This TextbookIt­is­the­hope­of­the­authors­and­editorsthat­this­textbook­will­provide­an­up-to-dateunderstanding­of­the­information­that­detailsthe­relationship­of­periodontal­disease­to­systemic­disease,­with­each­chapter­outlining­astate-of-the-art understanding­of­the­optimalmanagement­of­patients.­This­textbook­hasbeen­prepared­as­a­resource­for­dental­students,­dental­hygiene­students,­faculty­members­of­dental­educational­institutions,­andfor­dental­professionals­in­general.­We­alsobelieve­this­resource­will­prove­valuable­tostudents­as­well­as­practicing­members­ofother­health­professions­in­the­medical­community.­The­integration­of­medicine­and­dentistry­grows­daily,­and­a­common­resourcesuch­as­this­textbook­could­serve­as­a­constructive­tool­to­help­the­two­disciplineswork­collaboratively.The­editors­would­like­to­thank­the­authors­and­coauthors­for­theirrole­in­preparing